On the whole, Pacific people living in New Zealand are less healthy than other population groups. As part of the health system PHARMAC has a role to play to improve this situation - by providing access to new medicines and medical devices, and ensuring medicines and medical devices are being used effectively.

The purpose and mission of this Strategy is to make change happen to improve the health of Pacific peoples.

Strategy purpose: Support Pacific people in New Zealand to live healthy lives through improved and timely access to, and use of, medicines and medical devices.

Mission statement: Every Pacific person in New Zealand has access to, and understands the use of, the PHARMAC-funded medicines or medical devices they need.

In engaging with Pacific communities, we heard of the challenges and barriers that Pacific peoples are facing, such as navigating their way through a complex health system but also the opportunities and successes we can learn from and build on. We think that PHARMAC can help support Pacific peoples to live healthier lives, both through our own work, and by influencing other agencies and organisations working in health.

Why we have a Pacific Responsiveness Strategy

PHARMAC is part of the broader health system and, as such, we must both align with and complement other frameworks and strategies that already exist. Reflecting the New Zealand Health Strategy, PHARMAC’s Pacific Responsiveness Strategy particularly is consistent with the theme of ‘one team’ (kotahi te tīma) as we realise improving the health of Pacific communities requires a cross system approach that puts community at the centre. This strategy also aligns with the Ministry of Health’s ’Ala Mo’ui: Pathways to Pacific Health and Wellbeing 2014-2018 as well as the Medicines Strategy.

PHARMAC’s Pacific Responsiveness Strategy aligns with our future direction and builds on the success of PHARMAC’s Māori Responsiveness Strategy, Te Whaioranga. We recognise that while the health of Māori and Pacific peoples isn’t as good as other New Zealanders, the challenges and the underlying causes may be different. Therefore, it is important to acknowledge that effective solutions may be different and we must have the ability to respond accordingly. We recognise that Māori and Pacific peoples have millennia of kinship connections through tuakana-teina (older sibling-younger sibling) relationships, that are acknowledged and both respected in Aotearoa and throughout Te-Moana-nui-ō-Kiva (Cook Islands Māori for Te-Moana-nui-ā-Kiwa).

Our journey

We have worked with Pacific stakeholders and held fonos within Pacific communities in New Zealand during 2015 and 2016. We travelled from Whangarei to Dunedin to hear about the opportunities, challenges and barriers Pacific communities face in relation to medicines and medical devices.

From these conversations, we believe PHARMAC can influence health outcomes of Pacific peoples on three levels:

through connecting with Pacific communities directly

by embedding Pacific perspectives into PHARMAC as an organisation, and

by influencing change elsewhere in the health system.

These three levels of influence form the basis for PHARMAC’s Pacific Responsiveness Strategy 2017-2026.

Text description of this image

The three levels of influence for PHARMAC are:

person: connecting with Pacific peoples

organisation: embedding Pacific perspectives of health into PHARMAC

system: influencing change in the health system

Three levels of influence

Connecting with Pacific peoples within their communities

The first stage of this Strategy is to develop and build trusting relationships in Pacific communities. Initial connections have been made through our community engagement but PHARMAC needs to build, nurture and extend these relationships.

There are many providers and organisations already doing great work in Pacific communities, and we recognise the most effective way for us to connect with communities will be through these groups. Through developing these connections, PHARMAC will be in a better position to empower aiga, magafaoa, famili (families) to better understand medicines and ultimately improve access to, and use of, medicines and medical devices.

Embedding Pacific perspectives of health into PHARMAC

To understand the needs of Pacific peoples PHARMAC must deepen its understanding of Pacific culture, and ensure all relevant impacts and implications for Pacific people are factored into our work. We know that Pacific communities are diverse and complex, and a long-term commitment to learning and improving our responsiveness is required.

We will look to the success that Te Whaioranga has had in building expertise and capability in te ao Māori within the organisation, to help guide a similar enhancement of understanding and appreciation of Pacific perspectives.

Influencing change in the health system

The health system is complex and Pacific communities have told us that this complexity can be difficult to navigate and cause barriers to access. While many of the barriers Pacific peoples face are not within the direct control of PHARMAC, we do have an important influencing role in the health system and can help to work with other organisations to make the system more accessible to all Pacific peoples.

Stages of growth for PHARMAC’s Pacific Responsiveness Strategy

Over the period 2017-2026, PHARMAC will commit to having a renewed action plan every three years to ensure an enduring and lasting commitment to improving the health of Pacific peoples.

We have used the growth of the coconut tree, as a symbol that resonates with Pacific communities, to represent PHARMAC’s journey over the next ten years. The coconut tree is enduring and provides shelter and nutrients. It is an iconic symbol for all the Pacific and indicates that our Strategy is for all Pacific peoples.

The growth of the coconut tree on the following page illustrates the three stages PHARMAC will go through as the Strategy evolves over the next 10 years. The first action plan covers the first stage. This is the stage where our focus will be on planting the seed and making the soil fertile to enable our strategy to grow. In this critical stage we must ensure that PHARMAC is focusing on core activity that we must get right early on and then continue to build on in the future.

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The image shows a coconut palm, with roots as Stage One, the trunk as Stage Two, and the leaves and fruit as Stage Three.

Stage One - 2017 to 2019: Planting the seed

Lutu na niu ka lutu ki vuna (Fiji)

A coconut always falls to the base. There is always an inherent connection between the base of the tree and the fruit. A good foundation will always ensure good results.

Stage Two - 2020 to 2022: Supporting growth

Olaga fiafia o sala to poto sala se lumanai manula (Tuvalu)

Wisdom is the path to happiness and a bright future.

Stage Three - 2023 to 2026: Flourishing change

'Aufua'a Tefuli (Tonga)

Success is achieved by working hard, persistent and in collaboration among the community and the state.

STAGE ONE: Planting the seed (2017-2019)

Influence

Priorities

Actions

Achieved by year-end

What does success look like in 2019

COMMUNITY

Building relationships to develop trust and to demonstrate an ongoing commitment to Pacific communities

Engage with Pacific peoples and the health workforce to identify the areas of health need that are most important across Pacific communities

2017

PHARMAC better understands the health priorities for Pacific peoples and is tailoring activity to improve outcomes in these areas

PHARMAC has meaningful and ongoing relationships with Pacific communities (through organisations/ providers) focused on improving Pacific peoples access and use of medicines

Pacific peoples are receiving the right information to improve their understanding and use of funded medicines and medical devices

Ensure an appropriate level of resourcing to implement the strategy

2017

Seek out opportunities to partner with Pacific health providers where PHARMAC activity may particularly impact on specific Pacific population groups

2019

Developing effective communication channels to improve Pacific peoples access to information about medicines and their use

Extend analysis of data to strengthen the evidence base for PHARMAC’s Pacific-responsiveness work, including (but not limited to) the areas of health need as identified by Pacific communities

2018

Deliver culturally appropriate information to improve understanding of medicines/ treatments in the most important areas of health need

2019

Build a communication strategy in consultation/collaboration with appropriate Pacific expertise to begin developing a range of tools and resources to target communications to Pacific audiences

Incorporate the development of cultural awareness/ competence (including of Pacific) into staff career advancement templates and professional development resources

2017

PHARMAC staff can embed a Pacific perspective into their work through their increased awareness, understanding and knowledge

The impact of PHARMAC’s funding decisions on Pacific communities are being considered accurately and appropriately

PHARMAC’s policies and processes ensure that all relevant information for Pacific peoples’ is taken into account

PHARMAC’s external committees can demonstrate a Pacific perspective is being accounted for in the advice given to PHARMAC

Develop a Pacific Champions group who will champion the Strategy within PHARMAC to ensure a cross-organisation response

2017

Provide opportunities for staff to improve their cultural awareness and awareness of health disparities; such as:

A series of Pacific cultural training opportunities

External speakers

Recognising Pacific cultural days

Attendance at conferences related to Pacific health

2018

Introducing a Pacific focus to the way we work at PHARMAC

Enhance PHARMAC’s induction of new staff to include an overview of the Pacific Responsiveness Strategy and medicines access for Pacific people

2017

Further develop skills and knowledge within PHARMAC to ensure an understanding of Pacific culture, perspectives and health data is accurately taken into account under the Factors for Consideration ‘population groups experiencing health disparities’ for all funding decisions

2017

Embed the need to consider Pacific populations (and other population groups with health disparities) into responsible use of pharmaceuticals activities as appropriate

2019

Develop research tools to improve staff access to relevant Pacific research (and to other population groups experiencing health disparities)

2018

Change internal processes where required to ensure Pacific health considerations and perspectives are factored into PHARMAC’s work

2019

Ensure PHARMAC’s external advisory groups take into account, and provide high-quality advice on, considerations important to the health of Pacific people (and other population groups experiencing health disparities)

2019

SYSTEM

Aligning our tools and resources to provide better information to the wider health system about the health needs of Pacific peoples

Run dedicated seminars for health professionals to improve knowledge of health disparities in New Zealand, including the health of Pacific peoples

2018

Barriers being faced by Pacific peoples in the health system, in relation to access and use of medicines, are being addressed by PHARMAC in collaboration with others in the health system

More data and information is available and being used by others in the health system to address medicine access and use by Pacific populations

Facilitate or undertake research relating to access or use of medicines by Pacific people

2019

Develop a tool-kit to make data, resources and information on medicine use by Pacific people more accessible to Pacific communities and the wider health system

2019

Actively working with others to reduce cultural, system and language barriers to medicines use and access

Support the formation of a Pacific pharmacist group to further enhance the role of Pacific leadership in the pharmacy sector

2017

Share the Pacific Responsiveness Strategy with other government agencies and relevant health sector organisations, to share learnings/findings from the community fono

2017

Develop relationships with Pacific advisors in DHBs

2017

Engage with Ministry of Health on how we can address barriers to accessing medicines, including user charges for Pacific peoples and other population groups experiencing health disparities

2019

Work with the MoH, DHBs, the primary care sector and Pacific community health groups to consider how the system could collectively work together to improve the cultural, system and language barriers being faced by some Pacific populations (and other population groups with health disparities) to improve access and use of medicines

2019

Acknowledgements

PHARMAC has had the strong support and advice of PHARMAC’s Consumer Advisory Committee (CAC) throughout the process to date, and particularly our three Pacific members; Chair, David Lui, Tuiloma Lina Samu and Key Frost.

A special acknowledgement to Anne Fitisemanu, who championed and initiated the very first PHARMAC Pacific Responsiveness Strategy in 2010.

We would also like to acknowledge the extensive contribution of Chief Executive, Steffan Crausaz, Judith Urlich, PHARMAC staff, Te Roopu Awhina Māori, our kaumatua Bill Kaua, Māori and Pacific Manager, Ātene Andrews for their blessing and support; plus members of the PHARMAC Pacific Responsiveness Strategy Working Group.

Many thanks to Rachel Melrose, Hayden Holmes, Hew Norris, Duncan Chadwick and especially to Rebecca Elliott and Peter Alsop for their policy process, insights and thought leadership; Jennifer Geard and Stephen Boxall for the amazing design and graphics produced for the website and printed materials. A special thanks also to Agnes Tokuma.